The standard Medicare Part B premium is $185.00 per month in 2025, up from $174.70 in 2024. That’s the baseline most enrollees pay, but your actual cost depends on your income, when you enrolled, and whether you qualify for assistance. Beyond the monthly premium, you’ll also pay an annual deductible and 20% coinsurance on most services.
The Standard Monthly Premium
Most Medicare beneficiaries pay $185.00 per month for Part B in 2025, a $10.30 increase from the prior year. This premium is the same regardless of your health status or how often you use medical services. For 2026, the premium jumps to $202.90, an increase of $17.90.
The premium is typically deducted automatically from your Social Security check each month. If you don’t receive Social Security benefits yet, you can sign up for Medicare Easy Pay, which pulls the payment from your bank account on the 20th of each month. It can take six to eight weeks for automatic deductions to start, so you’ll need to pay another way during that gap.
Higher Premiums for Higher Earners
If your income exceeds certain thresholds, you’ll pay more than the standard premium through what’s called an Income-Related Monthly Adjustment Amount (IRMAA). Social Security determines your surcharge based on your tax return from two years prior. So your 2026 premium is based on your 2024 income.
For individuals filing single in 2026, the brackets work like this:
- $109,000 or less: standard premium of $202.90
- $109,001 to $137,000: $284.10 per month
- $137,001 to $171,000: $405.80 per month
- $171,001 to $205,000: $527.50 per month
- $205,001 to $499,999: $649.20 per month
- $500,000 or more: $689.90 per month
For married couples filing jointly, the income thresholds are roughly doubled. The lowest IRMAA tier kicks in above $218,000, and the highest bracket starts at $750,000. If you’re married filing separately, the brackets are much narrower: income above $109,000 pushes you to $649.20 per month, and $391,000 or more means $689.90.
If your income has dropped significantly since the tax year Social Security is using (because of retirement, divorce, death of a spouse, or other life-changing events), you can request a reconsideration to lower your premium.
Deductible and Coinsurance
Before Part B starts covering services, you need to meet an annual deductible. In 2025, that deductible is $257. It rises to $283 in 2026. You pay this once per calendar year, not per visit or per condition.
After you’ve met the deductible, Part B covers 80% of approved services and you pay the remaining 20% as coinsurance. There’s no annual cap on that 20%, which is one reason many people carry supplemental insurance (Medigap) or enroll in a Medicare Advantage plan. A single hospitalization or series of specialist visits can make that 20% add up quickly. Some preventive services, like annual wellness visits and certain screenings, are covered at 100% with no coinsurance.
Late Enrollment Penalties
If you don’t sign up for Part B when you’re first eligible and you don’t have qualifying coverage through an employer, you’ll face a permanent penalty. The surcharge is 10% added to your premium for every full 12-month period you delayed enrollment. So if you waited two years, your premium goes up 20% for as long as you have Part B, which for most people means the rest of their life.
This penalty applies even if you were healthy and didn’t think you needed coverage during those years. The only exception is if you qualified for a Special Enrollment Period, typically because you or your spouse had employer-based health insurance during the gap.
Help Paying Part B Costs
If you have limited income and savings, Medicare Savings Programs run by your state can help cover Part B premiums, deductibles, and coinsurance. There are three main tiers, each with different income limits for 2026:
- Qualified Medicare Beneficiary (QMB): covers premiums, deductibles, and coinsurance. Individual income limit of $1,350 per month with resources under $9,950.
- Specified Low-Income Medicare Beneficiary (SLMB): covers the Part B premium only. Individual income limit of $1,616 per month with the same resource cap.
- Qualifying Individual (QI): also covers the Part B premium. Individual income limit of $1,816 per month.
For married couples, the income limits are higher (ranging from $1,824 to $2,455 per month depending on the program), and the resource limit is $14,910. Limits are slightly higher in Alaska and Hawaii, and some states set their own thresholds above the federal minimums. You apply through your state Medicaid office.
Total Annual Cost at a Glance
For someone paying the standard premium in 2025, the fixed costs alone come to $2,477 per year: $185 multiplied by 12 months ($2,220) plus the $257 deductible. On top of that, you’ll owe 20% of whatever Medicare-approved services you receive. In 2026, those fixed costs rise to $2,717.80 before coinsurance.
If you’re in a higher IRMAA bracket, the math shifts considerably. At the top tier in 2026, premiums alone cost $8,278.80 per year before you’ve seen a single doctor. For most enrollees, though, the standard premium plus a Medigap or Medicare Advantage plan is the practical budget to plan around.